Characteristics of survivors and non-survivors of severe obstetric sepsis following critical care admission
| Severe sepsis survivors | Severe sepsis deaths | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
|---|---|---|---|---|
| n=610 | n=29 | |||
| Recently pregnant | 387 (63.4) | 22 (75.9) | 1.8 (0.76 to 4.3) | 1.1 (0.42 to 3.0) |
| Maternal age, years | ||||
| <25 | 234 (38.4) | 5 (17.2) | 1* | 1* |
| 25–34 | 254 (41.7) | 15 (51.7) | 2.8 (0.99 to 7.7) | 2.2 (0.71 to 7.0) |
| ≥35 | 121 (19.9) | 9 (31.0) | 3.5 (1.1 to 10.6) | 3.3 (0.94 to 11.2) |
| Non-white ethnicity | 147 (24.1) | 7 (24.1) | 0.98 (0.39 to 2.5) | 0.59 (0.21 to 1.6) |
| Deprivation (IMD quintiles 4 and 5) | 354 (58.1) | 17 (58.6) | 1.02 (0.48 to 2.2) | 2.6 (1.03 to 6.7) |
| BMI, kg/m2 | ||||
| Unknown | 317 (52.1) | 13 (44.8) | 0.78 (0.17 to 3.7) | 1.2 (0.15 to 9.1) |
| <25 | 126 (20.7) | 3 (10.3) | 1* | 1* |
| ≥25<30 | 90 (14.8) | 7 (24.1) | 3.3 (0.8 to 13.3) | 5.2 (1.4 to 18.9) |
| ≥30 | 76 (12.5) | 6 (20.7) | 3.5 (0.9 to 14.6) | 6.3 (1.5 to 27.0) |
| History of immunosuppression | 13 (2.1) | 2 (6.9) | 3.3 (0.73 to 15.7) | |
| Weeks gestation | ||||
| Antenatal | ||||
| ≥37 | 16 (7.0) | 0 (0.0) | – | |
| 25–36 | 104 (47.5) | 3 (42.9) | 1* | |
| <25 | 99 (45.2) | 4 (57.1) | 1.4 (0.31 to 6.4) | |
| Postnatal | ||||
| ≥37 | 202 (54.9) | 14 (66.7) | 1* | |
| 25–36 | 114 (31.0) | 3 (14.3) | 0.38 (0.11 to 1.3) | |
| <25 | 52 (14.1) | 4 (19.1) | 1.1 (0.35 to 3.5) | |
| Recently pregnant women only | ||||
| Parity | ||||
| 0 | 183 (48.9) | 9 (42.9) | 1* | |
| 1 | 88 (23.5) | 7 (33.3) | 1.6 (0.58 to 4.5) | |
| ≥2 | 103 (27.5) | 5 (23.8) | 1.0 (0.32 to 3.0) | |
| Assisted conception | 24 (8.7) | 0 (0.0) | – | |
| Mode of delivery | ||||
| Spontaneous vaginal | 89 (23.6) | 8 (36.4) | 1* | |
| Assisted vaginal | 28 (7.4) | 0 (0.0) | – | |
| Caesarean section | 227 (60.2) | 12 (54.6) | 0.59 (0.23 to 1.5) | |
| Termination | 23 (6.1) | 2 (9.1) | 0.97 (0.19 to 4.9) | |
| Ectopic | 10 (2.7) | 0 (0.0) | – | |
| All multiple births | 24 (7.0) | 3 (15.0) | 2.3 (0.64 to 8.6) | |
| Stillbirth(s) | 42 (21.9) | 4 (33.3) | 1.8 (0.5 to 6.2) | |
| Hysterectomy | 16 (4.6) | 3 (15.0) | 3.6 (0.96 to 13.7) | |
| <24 hours since delivery | 104 (27.6) | 8 (36.4) | 1.5 (0.61 to 3.7) | |
| Source of infection† | ||||
| Pneumonia (chest infection) | 216 (35.4) | 12 (41.4) | 1.3 (0.60 to 2.7) | |
| Intrauterine infection | 69 (11.3) | 2 (6.9) | 0.58 (0.13 to 2.5) | |
| Pelvic infection | 47 (7.7) | 0 (0.0) | – | |
| UTI/pyelonephritis | 43 (7.1) | 0 (0.0) | – | |
| Septicaemia‡ | 17 (2.8) | 2 (6.9) | 2.6 (0.57-11.7) | |
| Number of organ system dysfunctions | ||||
| 1 | 221 (36.2) | 2 (6.9) | 1* | |
| 2 | 224 (36.7) | 8 (27.6) | 3.9 (0.83 to 18.7) | |
| ≥3 | 165 (27.1) | 19 (65.5) | 12.7 (2.9 to 55.1) | |
| Organ system dysfunction§ | ||||
| Cardiovascular | 444 (72.8) | 24 (82.8) | 1.8 (0.68 to 4.8) | |
| Respiratory | 349 (57.2) | 26 (89.7) | 6.5 (1.9 to 21.6) | 8.1 (1.8 to 36.0) |
| Metabolic acidosis | 322 (52.8) | 18 (62.1) | 1.5 (0.68 to 3.1) | |
| Renal | 39 (6.4) | 8 (27.6) | 5.6 (2.3 to 13.4) | 2.9 (0.94 to 9.3) |
| Haematological | 52 (8.5) | 11 (37.9) | 6.5 (2.9 to 14.6) | 5.7 (2.0 to 16.0) |
Bold typeface indicates statistically significant results. Figures are numbers (%) of women.‘–’ indicates OR estimate not possible due to zero incidence in either the case or control group.
*Reference group.
†Reasons for admission with a >5% frequency.
‡Admitted with or onset during critical care admission.
§Organ system dysfunctions not mutually exclusive.
BMI, body mass index; IMD, Index of Multiple Deprivation; UTI, urinary tract infection.